Press Alt + R to read the document text or Alt + P to download or print.
This document contains no pages.
HomeMy WebLinkAboutBLDE-22-003216 Commonwealth of Official Use Only
irC , Massachusetts Permit No. BLDE-22-003216
BOARD OF FIRE PREVENTION REGULATIONS Occupancy and Fee Checked
[Rev.1/07]
APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK
All work to be performed in accordance with the Massachusetts Electrical Code (MEC),527 CMR 12.00
(PLEASE PRINT IN INK OR TYPE ALL INFORMATION) Date:12/7/2021
City or Town of: YARMOUTH To the Inspector of Wires:
By this application the undersigned gives notice of his or her intention to perform the electrical work described below.
Location(Street&Number) 61 WEBBERS PATH
Owner or Tenant Jason Pratt Telephone No.
Owner's Address MA
Is this permit in conjunction with a building permit? Yes 0 No 0 (Check Appropriate Box)
Purpose of Building Utility Authorization No.
Existing Service Amps Volts Overhead 0 Undgrd 0 No.of Meters
New Service Amps Volts Overhead 0 Undgrd 0 No.of Meters
Number of Feeders and Ampacity
Location and Nature of Proposed Electrical Work: Rewire house after fire.
Completion of the following table may be waived by the Inspector of Wir s.
No.of Recessed Luminaires No.of Ceil.-Susp.(Paddle)Fans No.of Total
Transformers KVA
No.of Luminaire Outlets No.of Hot Tubs Generators KVA
No.of Luminaires Swimming Pool Above 0 In- ❑ No.of Emergency Lighting
grnd. grnd. Battery Units
No.of Receptacle Outlets No.of Oil Burners FIRE ALARMS No.of Zones
No.of Switches No.of Gas Burners No.of Detection and
Initiatine Devices
No.of Ranges No.of Air Cond. Tonal No.of Alerting Devices
No.of Waste Disposers Heat Pump Number Tons KW No.of Self-Contained
Totals: Detection/Alertine Devices
No.of Dishwashers Space/Area Heating KW Local ❑ Municipal ❑ Other:
Connection
No.of Dryers Heating Appliances KW Security Systems:*
No.of Devices or Equivalent
No.of Water KW No.of No.of Ballasts Data Wiring:
Heaters Siens No.of Devices or Equivalent
No.Hydromassage Bathtubs No.of Motors Total HP Telecommunications Wiring:
No.of Devices or Equivalent
OTHER:
Attach additional detail if desired,or as required by the Inspector of Wires.
Estimated Value of Electrical Work: (When required by municipal policy.)
Work to start: Inspection to be requested in accordance with MEC Rule 10,and upon completion.
INSURANCE COVERAGE:Unless waived by the owner,no permit for the performance of electrical work may issue unless the licensee provides
proof of liability insurance including"completed operation"coverage or its substantial equivalent.The undersigned certifies that such coverage
is in force,and has exhibited proof of same to the permit issuing office.
CHECK ONE:INSURANCE 0 BOND 0 OTHER 0 (Specify:)
I certify,under the pains and penalties of perjury,that the information on this application is true and complete.
FIRM NAME: Richard A Haarman
Licensee: Richard A Haarman Signature LIC.NO.: 13615
(If applicable,enter"exempt"in the license number line.) Bus.Tel.No.:
Address: 18 Holmes Rd, Harwich MA 026452219 Alt.Tel.No.:
*Per M.G.L.c. 147,s.57-61,security work requires Department of Public Safety"S"License:
OWNER'S INSURANCE WAIVER:I am aware that the License does not have the liability insurance coverage normally required by law.But my
signature below,I hereby waive this requirement.I am the(check one) 0 owner 0 owner's agent.
Owner/Agent
Signature Telephone No. PERMIT FEE:$150.00
V `�� q-/e(R-r_ �
Cosmorama&O`Maseociirr rdatte Official Use Only
w �' e7 Permit No. " --2---/-- '3'32-1
opartrastri
Occupancy and Fee Checked
BOARD OF FIRE PREVENTION REGULATIONS [Rev.1/07] (leave blank)
APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK
All work to be performed in accordance with the Massachusetts Electrical Code(MEC),527 CMR 12.00
) (PLEASE PRINT IN INK OR TYPE ALL INFORMATION) Date: 11/30/2021
2. City or Town of: Yarmouth To the Inspector of Wires:
.f. By this application the undersigned gives notice of his or her intention to perform the electrical work described below.
Location(Street&Number)61 Webbers Path
J Owner or Tenant Jason Pratt Telephone No.
C Owner's Address 61 Webbers Path W.Yarmouth, MA 02673
Is this permit in conjunction with a building permit? Yes 0 No ® (Check Appropriate Box)
Purpose of Building Utility Authorization No.
Existing Service Amps / Volts Overhead Undgrd❑ No.of Meters
---', New Service Amps / Volts Overh Undgrd❑ No.of Meters
lA . Number of Feeders and Ampadty
Location and Nature of Proposed Electrical Work: Rewire Dwelling After Fire
8
vlCompletion of thefollowi table nt /n be waived by the ctor of Wires.
lb No.of Recessed Luminaires No.of Cil.-Sasp.(Paddle)Fans To.of K
Transformers KVAVA
Q No.of Luminaire Outlets No.of Hot Tubs Generators KVA
No.of Luminaires Swimming p� Above ❑ In- ❑ No.of Emergency Lighting
fond. crud. Battery Units
`J No.of Receptacle Outlets No.of Oil Burners FIRE ALARMS No.of Zones
z No.of Switches No.of Gas Burners 'No.of Detection and
Initiating Devices
ota
IQ No.of Ranges No.of Air Cond. Tl No.of Alerting Devices
ons
Heat PumpNumber Tons KW No.of Self-Contained
No.of Waste Disposers Totals: _ .____..._.�_.___..__.__._.._ Detection/Akr�Devic s
No.of Dishwashers �un nothir
Space/Area Heating KW onnection
No.of Dryers Heating Appliances Key Seca •*
No.of Water No.of or Equivalent
Heaters KW No.of No.of Data Wiring:
Signs Ballasts No.of Devices or ' .uivalent _
No.Hydromassage Bathtubs No.of Motors Total HP Tel Ngo.of Devices or " ! '
OTHER:
Attach additional detail if desired or as required by the Inspector of Wires.
Estimated Value of Electrical Work: (When required by municipal policy.)
Work to Start: Inspections to be requested in accordance with MEC Rule 10,and upon completion.
INSURANCE COVERAGE: Unless waived by the owner,no permit for the performance of electrical work may issue unless
the licensee provides proof of liability insurance including"completed operation"coverage or its substantial equivalent. The
undersigned certifies that such coverage is in force,and has exhibited proof of same to the permit issuing office.
CHECK ONE: INSURANCE■ BOND 0 OTHER 0 (Specify:)
I cerltffy,under the pains and , , ,, ofpedury,that the information n this application is true and complete 36 (5
-114—
FIRM NAME:Snows Fuel,LLC LIC.NO.:8175 Al
Licensee: Richard A Haarman Signature ALIC.NO.:
(If applicable,enter"exempt"in the license number line.) Bus.TeL No.:508-255-1090
Address: 18 Main St Alt.Tel.No.:508-789-5410
*Per M.G.L.c. 147,s.57-61,security work requires Department of Public Safety"S"License: Lic.No.
OWNER'S INSURANCE WAIVER: I am aware that the Licensee does not have the liability insurance coverage normally
required by law. By my signature below,I hereby waive this requirement. I am the(check one)0 owner 0 owner's agent.
Owner/Agent
Signature Telephone No. PERMIT FEE:$